Using the WHOQOL-BREF in persons with dementia: a validation study

Increasing evidence suggests that persons with early dementia can give reliable and valid assessments about their own quality of life (QOL), thereby improving accuracy, and reducing the need for proxy informants. The objective of this study was to examine QOL in persons diagnosed with dementia (Diagnostic and Statistical Manual of Mental Disorder-IV) using a battery of subjective assessments including the new World Health Organization Quality of Life (WHOQOL-BREF). Persons with mild-to-moderate dementia (n=104) were recruited and interviewed at 6 Spanish centers to obtain sociodemographic information, health perceptions, depressive symptoms (Geriatric Depression Scale 15-item version), functional ability (Barthel Index), generic QOL (WHOQOL-BREF), and specific QOL (DEMQOL-28). Analysis was performed using classical psychometric methods. Internal consistency reliability for the WHOQOL-BREF domains ranged from moderate (0.54 for social) to good (0.79 for psychological). Test-retest reliability (intraclass correlation) ranged from moderate (0.51 for psychological) to good (0.70 for physical). Associations were confirmed between WHOQOL-BREF domains with DEMQOL-28, Geriatric Depression Scale 15-item version, and Barthel dimensions. With regard to contrasting groups' differences, WHOQOL-BREF scores significantly differentiated between healthy and unhealthy and depressed and nondepressed participants. This study is the first to report on the use of the WHOQOL-BREF in persons with mild-to-moderate dementia. These results indicate that it is a useful tool in assessing these groups, as it includes important dimensions commonly omitted from other dementia measures.